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155 Clinically-oriented assessments of hamstring muscle strength are reliable
  1. Ellevyn Irwin,
  2. Grainne O’Callaghan,
  3. Aine Tunney,
  4. Eamonn Delahunt,
  5. Ulrik McCarthy Persson
  1. University College Dublin, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland


Background Hamstring muscle strain injuries are a prevalent non-contact injury incurred by field sport athletes. A low level of hamstring muscle strength has been reported to be a risk factor for hamstring muscle strain injury, whereby reliable, clinically-oriented assessments of hamstring muscle strength are required to assist clinicians to implement ‘targeted’ injury prevention strategies and make objective return-to-participation/sport decisions.

Objective To evaluate the interrater reliability of five different clinically-oriented assessments of hamstring muscle strength.

Design Interrater reliability study.

Setting Sports clubs.

Patients (or Participants) Twenty male field-sport athletes with no reported history of hamstring muscle strain injury within the previous 6 months participated.

Interventions (or Assessment of Risk Factors) Three sports physiotherapists independently assessed participants’ hamstring muscle strength using the following clinically-oriented assessments: (1) supine mid-range maximum voluntary isometric contraction (MVIC); (2) prone inner-range MVIC; (3) prone mid-range MVIC; (4) prone mid-range ‘eccentric break’; (5) supine outer-range ‘eccentric break’.

Main Outcome Measurements Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CI) were calculated to determine interrater reliability. We chose the ICC (2,3) model, which corresponds to a 2-way mixed model, with measurement of the mean of 3 raters and absolute agreement.

Results Excellent interrater reliability was demonstrated for the supine mid-range MVIC (ICC=0.86; 95% CI = 0.70–0.94) and prone mid-range MVIC (ICC=0.79; 95% CI = 0.60–0.91). Good interrater reliability was demonstrated for the prone inner-range MVIC (0.72; 95% CI = 0.44–0.88), prone mid-range ‘eccentric break’ (ICC=0.67; 95% CI = 0.33–0.85), and supine outer-range ‘eccentric break’ (ICC=0.67; 95% CI = 0.34–0.85). The highest and lowest force values were registered during the supine outer-range ‘eccentric break’ (310±57.8N) and prone inner-range MVIC (127±31.4N), respectively.

Conclusions Clinically-oriented assessments of hamstring muscle strength are reliable. These assessments can be used as an integral part of injury prevention, rehabilitation progression and objective return-to- sport decisions.

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